Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN2268553 | MA |
Y | 363LN0000X | Nurse Practitioner - Neonatal | RN2268553 | MA |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN2268553 | MA |
NPI | 1225315377 |
---|---|
Provider Name | Meghan L Beaulieu |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01605-2903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2011 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110094760A | (05) | MA |
S400341766 | MEDICARE (01) | MA |